Prevalence and Predictors of Diarrhoea in Under-Fives Presenting with Malaria in University of Benin Teaching Hospital, Benin City, Nigeria

Abstract

Introduction: Malaria and diarrhoea are the two of the most common childhood killer diseases world-wide. There have been varying findings from published data on the interaction between malaria and diarrhoea.

Objective: To determine the prevalence and to identify predictors of diarrhoea in under-fives with malaria.

Subjects and Methods: Subjects were children (6 months – 59 months) diagnosed with malaria using blood film microscopy seen from June 2012 to July 2013 in University of Benin Teaching Hospital, Benin City, Nigeria. Interviewer administered-questionnaires were used to obtain data from caregivers about symptoms of malaria and diarrhoea. Malaria was categorized as complicated or uncomplicated using the World Health Organization criteria.

Results: Two hundred well-nourished children [male 118 (59.0%); female 82 (41.0%)] malaria positive children; mean ± (SD) age 20.8 ± 14.2 months were recruited for this study. Prevalence of diarrhoea in malaria was 33.5%. Age was significantly associated with the presence of diarrhoea in children with malaria; infants (aged 6 – 11 months) (49.5%) being significantly more likely to have malaria-diarrhoea co-morbidity (β = -0.04, OR = 1.0, p = 0.002). The mean ± (SD) parasite count of children with malaria-diarrhoea co-morbidity (2085.82 ± 1500.02 per μL) was higher than those with malaria and no diarrhoea (1828.65 ± 1216.66 parasites per μL). Severe anaemia, hyperpyrexia and multiple convulsions significantly predicted diarrhoea as co-morbidity in children with malaria.

Conclusion: A significant proportion of under-fives with malaria also had diarrhoea. Infants and children with malaria associated with severe anaemia, hyperpyrexia and multiple convulsions are more likely to have diarrhoea as co-morbidity.

Keywords: co-morbidity, diarrhoea, malaria, microscopy